Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents for follow-up of known portal hypertension. EGD reveals mild portal hypertensive gastropathy characterized by a mosaic-like pattern of the gastric mucosa, primarily in the fundus and body. No evidence of active bleeding, cherry-red spots, or acute erosions. Patient denies hematemesis, melena, or symptomatic anemia.
Clinical Examination Findings
Abdominal examination reveals stable hepatosplenomegaly consistent with chronic liver disease. No evidence of tense ascites or abdominal wall collateral circulation (caput medusae). Cardiovascular exam is regular; no signs of hemodynamic instability. Skin shows no evidence of palmar erythema or spider angiomata.
Treatment Protocol
Continue current management of underlying portal hypertension. Maintain non-selective beta-blocker therapy (e.g., Propranolol or Nadolol) as tolerated to reduce portal venous pressure. Monitor hemoglobin and ferritin levels periodically. Avoid NSAIDs and alcohol to prevent mucosal injury. Repeat EGD surveillance as per clinical guidelines.